12488 (AR)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 45--305 Desert FOX Drive LA QUINTA, CALIFORNIA 92253
I Owner
PERMIT.
Alan
Lulou
'
• Mailing
Address Same
139.16
Const.
City
Quints r
�&.
J'iP92253
Te1.
Contractor
Plumbing
36.00
Santa Rosa
D,6valopaient;
Inc.
Address
Driveway Enc.
45-275 Desert Eagle Court-
ourts.CN
CN
Quiiltsi,
A
ZIP�2253
Tel 345- 1216
' State Lic.
City
& Classif. 684118
Lic. # 2429
r Arch., Engr.,
REMARKS
Designer
Address
Tel.
City r' ) State
Zi P
�.• , Lic.
i' LICENSED CONTRACTOR:&DECLARATION�
I hereby affirm°that I am licensed under-proiviv sions of Chapter 96(commencing with Section
000) of Divvision 3 of the �Businesscand.ProfF! sionsf;Cod_e,,and,my_license,is'ih full force and
OWNER-BUILPER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
i Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
ubjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will
o the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
` uilds or improves thereon and who does such work himself or through his own employees,
!- provided that' such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
i does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
Date Owner
i
I WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker'2,Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poli�cy,A�o. _Company
i f�' Copy is filed with the -city. ❑ Certified copy is hereby furnished.
- c
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT., It, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST
P. Number
No.
OCC: GRP.
Legal Description
Project Description Guest House
1248E
Sq. Ft. No. No. Dw.
Size Stories Units
New O Add O Alter O Repair ❑ 'Demolition 0
Estimated Valuation $14,644.00
PERMIT.
AMOUNT
Plan ChODep.
'
Plan Chk. Bal.
139.16
Const.
162.00
Mech.
32.50
Electrical
24..80
Plumbing
36.00
.S. M. I .
1.46
Grading
20.00
Driveway Enc.
Infrastructure
TOTAL
5. 92
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line Y �'
Side Setback from Properiy__Line !
FINAL DATE I
Issued by: -
Validated t
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. @ $
UNITS
COLL. AREA
E
3
Y
ARD SPKLR SYSTEM
2ND FL. SD. F7. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. S0. F7. @
DUCT WORK
ROCK STORAGE
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. @
GAS (FINAL)
WALL SO. F7. @
DRINKING FOUNTAIN
SQ. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
NAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
% %
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
LATH I NG "'j'Oj w
MESH
SQ.FT.GAR @ 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK ��
GROUND PLUMBING) s9�
NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE (`
3
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. t
S (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING(( 3 Q3
NAL INSP.
ROOFING' //�� &A,
% %
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALLthga
LATH I NG "'j'Oj w
MESH
INSULATION/SOUND L R�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL